What Do Transgenders Really Want?
With full awareness that transgendered people are as diverse as any ethnic, occupational or geographical community, I still think this question merits pondering. Despite diversity in the areas of acculturation, socio-economic status, education and numerous other aspects of life, there still remains a thread that binds and defines transgender people. It is their experience of being of a different gender than is apparent to the world and of trying to find a satisfying way to express this experience. From this point TGs diverge. The intensity, frequency and manner of expression varies as do individuals' tolerance for frustrated expression. For some expression is a preference, for others a need. Some need a "fix" periodically; for others only a fully elaborated cross-gendered life-style will satisfy. Some blossom as they transition, emerging as more productive and creative than they were when living an unauthentic existence. Others unravel under the stress of confronting criticism, ridicule and discrimination and suffer family and financial reverses that offset the satisfaction of living an authentic lifestyle.
Taking the above into account, it does seem that most TGs do have a few common expectations, needs and goals. First, I think they would like to be seen as individuals with a variance in gender identity, rather than a mental illness or disorder. Is this splitting hairs? It wouldn't be in a society that didn't pathologize psychological disorders. However, it is difficult to elicit respect and interest from others when viewed as mentally unfit.
Second, those TGs who require medical treatment to bring gender identity and body into consonance want the same access to the required treatment as a person who suffers an amputation, a mastectomy or a hormonal birth defect. None of these individuals needs to convince a mental health practitioner that they are "truly" wanting and needing a prosthesis, breast reconstruction or hormone replacement therapy for missing testes or ovaries. Because TGs are aware that much of the pressure on the medical community to gatekeep is fueled by the fear of legal liability, some would forgo the right to sue in exchange for the privilege of dictating their own medical regime.
Third, they report they want legal protection against discrimination because of gender identity. We in San Francisco and in a few other cities, as well as the state of Minnesota, are far ahead of the rest of the U. S. in this respect.
Fourth, transgenders wish for more research on the long term biological effects of hormones and improved surgical techniques, especially for FTMs.
Fifth, they would like graduate schools that prepare mental health care givers for practice to provide education in the areas of human sexuality and gender identity. Following that, they would have licensing boards require that candidates demonstrate some understanding of the experience of gender identity dissonance. Then they would like to be able to locate and access these professionals in a range of practice settings such as mental health clinics, university centers, and private practices.
Sixth, they want health insurance coverage for their medical and psychological treatment to parallel that of non-TG policy holders seeking comparable services.
Lastly, they wish for successful and accomplished TGs to stand up and be counted among their brothers and sisters not yet or still in transition. The lack of role models is a major disadvantage to TG youth in particular, but to all people struggling with gender identity issues at every stage of life.
I know this is not a comprehensive list, but it's a start. Additions are welcome and future columns will incorporate your contributions.
Dr. Anderson is located at 1537 Franklin St, Suite 104, San Francisco, CA 94109, 415-776-0139.
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